Abstract
BackgroundChronic pelvic pain (CPP) is a lower abdominal pain lasting at least 6 months, occurring continuously or intermittently and not associated exclusively with menstruation or intercourse. Although the musculoskeletal system has been found to be involved in CPP, few studies have assessed the contribution of posture in women with CPP. We aimed to determine if the frequency of postural changes was higher in women with CPP than healthy subjects.MethodsA case-control study included 108 women with CPP of more than 6 months' duration (CPP group) who consecutively attended at the Hospital of the University of São Paulo and 48 healthy female volunteers (control group). Postural assessment was noninvasive and performed in the standing position, with the reference points of Kendall used as normal parameters. Factors associated with CPP were assessed by logistic regression analysis.ResultsLogistic regression showed that the independent factors associated with CPP were postural changes in the cervical spine (OR 4.1; 95% CI 1.6–10.7; p < 0.01) and scapulae (OR 2.9; 95% CI 1.1–7.6; p < 0.05).ConclusionMusculoskeletal changes were associated with CPP in 34% of women. These findings suggest that a more detailed assessment of women with CPP is necessary for better diagnosis and for more effective treatment.
Highlights
Chronic pelvic pain (CPP) is a lower abdominal pain lasting at least 6 months, occurring continuously or intermittently and not associated exclusively with menstruation or intercourse
This disease has been associated with musculoskeletal changes [9] and particular postures [11], to date there have been no studies of the detailed postural evaluation of women with CPP, which can be performed by attending physicians, especially primary care physicians [5] and gynecologists [12]
We observed a postural difference between the CPP and control groups, the difference was statistically significant (p < 0.01) only for the upper segments of the body, i.e., the cervical spine and scapulae
Summary
Chronic pelvic pain (CPP) is a lower abdominal pain lasting at least 6 months, occurring continuously or intermittently and not associated exclusively with menstruation or intercourse. Postural changes are frequently observed among women with CPP. This disease has been associated with musculoskeletal changes [9] and particular postures [11], to date there have been no studies of the detailed postural evaluation of women with CPP, which can be performed by attending physicians, especially primary care physicians [5] and gynecologists [12]. Postural assessment can lead to early detection of uneven positions, shortenings, antalgic postures and tensions These changes may not be the primary cause of the clinical condition, they can contribute significantly to the worsening of pain and tension. We determined the frequency of postural changes in women with CPP, as assessed only by clinical examinations
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